Review of extraosseous and intraosseous blood supply of the carpal bones

Abstract

The blood supply of the carpal bones has been updated and described with new dissection, vascular filling and imaging techniques. It is very important to know the vascular anatomy of the carpal bones in order to predict vascular insufficiency and associated avascular necrosis that may occur as a result of any injury such as fracture. This article reviews the extraosseous and intraosseous vascular supply of the carpal bones. The carpal bones are supplied by three vascular arches formed by the radial, ulnar and anterior interosseous arteries on the dorsal and palmar sides of the wrist. These contribute to the dorsal and palmar carpal vascular systems, which consist of transverse arteries connected by longitudinal anastomoses. The scaphoid and capitate have a high risk of avascular necrosis, while the trapezium, triquetrum, pisiform and 80% of the lunate have a lower risk. With the development of new imaging techniques, new information is added to the literature. With the increase in three-dimensional studies, intraosseous vascularity and its correlation with carpal bone fractures and its relationship with avascular necrosis will be revealed more clearly.